WHO plans to ‘strangle’ drug-resistant TB

A TB patient in South Africa Copyright: Gary Hampton, World Lung Foundation

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The World Health Organization (WHO) has announced a new two-year, US$2.15 billion plan to prevent, treat and control drug-resistant tuberculosis.

If fully implemented, hundreds of thousands of drug-resistant tuberculosis (TB) cases could be prevented and the lives of 1.2 million patients saved.

The ‘Global MDR-TB and XDR-TB Response Plan 2007-2008’, launched 22 June, details the steps required to provide access to drugs and diagnostic tests for all drug-resistant TB patients by 2015, and identifies costs, milestones and priorities for health services.

The WHO has expressed concern over the rising incidence of drug resistance in TB patients, which can emerge when patients do not take medication at the prescribed dose and intervals.

The new WHO plan outlines steps to increase the number of TB laboratories in countries with high levels of TB so that detection and treatment of resistant cases can be increased ten-fold. 

Eighty per cent of the budget will be designated for country needs, with the remaining sum to support global, regional and national activities by international partners.

The WHO estimates there are 424,000 new cases of multidrug-resistant TB (MDR-TB) each year, where patients do not respond to the two main first-line anti-TB drugs, rifampicin and isoniazid. It says the cost of treating MDR-TB is 1,000 times higher than treating ordinary TB patients.

Extensively drug-resistant (XDR-TB) is a virtually untreatable form of MDR-TB, where patients do not respond to at least four anti-TB drugs. The WHO estimates 25,000–30,000 new cases of XDR-TB every year.

Thirty-seven countries have reported cases of XDR-TB since it was first highlighted in 2006, when South Africa reported a cluster of “virtually untreatable” XDR-TB cases in an area with high HIV prevalence. 52 of the 53 patients died within 25 days of diagnosis.

“It is an ambitious plan that must be fully supported if we are to keep a stranglehold on drug-resistant TB,” says Mario Raviglione, director of the WHO’s Stop TB Department, in a press release.

The India office of the international organisation Médecins Sans Frontières (MSF) said in a report released on World TB Day (24 March) that resistant strains of tuberculosis are spreading at alarming rates due to lack of adequate tools to diagnose, treat or prevent them. 

Diagnosing drug resistant TB requires more rapid and repeated tests, says Nana Zarkua, medical coordinator at MSF’s India office. It takes more than a week to get a result and tests need to be repeated to know which drug a patient has become resistant to.